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2020 Australian Pain Society 40th Annual Scientific Meeting

2020 Australian Pain Society 40th Annual Scientific MeetingIn the IASP Global Year for the Prevention of Pain5 - 8 April 2020 | Hotel Grand Chancellor, Hobart TAS

Topical Session Outlines

Please click below for session outlines and confirmed speakers

Topical Sessions 1 - Monday 6 April 2020, 10.45 am - 12.15 pm

Topical Sessions 2 - Monday 6 April 2020, 1.45 pm - 3.15 pm

Topical Sessions 3 - Tuesday 7 April 2020, 1.45 – 3.00 pm and 3.30 pm - 5.00 pm


Topical Sessions 1

Monday 6 April 2020, 10.45 am - 12.15 pm

1A: Pain management along the cancer disease spectrum

Chair: Dr Tim Andrewartha, Saunders St Clinic / NW Specialist Palliative Care Service, TAS, Australia

Cancer pain can be debilitating and difficult to treat. What receives less focus, however, is pain at the extremes of the cancer disease spectrum - that is, pain in cancer survivorship and pain during palliative care for cancer. This session will bring together three speakers to explore pain management in cancer care.

A/Professor Melanie Lovell from HammondCare and University of Sydney will speak on her research implementing the Australian Cancer Pain Guideline in cancer centres around Australia. Then Ms Julie Allen, a physiotherapist from Queensland and creator of the Pentimento Project, will provide a lived experience of cancer survivorship including the challenges of the medical system following remission and how this inspired her to use her physiotherapy training to develop an exercise and wellness program for such a population. Last, Associate Professor Brian Le, Director of Palliative Care at the Peter MacCallum Cancer Centre will discuss improving end of life care in a cancer center and integrating palliative care into cancer care.

A/Professor Melanie Lovell, University of Sydney, NSW, Australia
Julie Allen, The Pentimento Project, QLD, Australia
A/Professor Brian Le, Victorian Comprehensive Cancer Centre, VIC, Australia

1B:  Interventional Pain Procedures: What works well and why?

Chair: A/Professor Stephanie Davies, Painless Health, WA, Australia

This topical session will cover the rational for multidisciplinary approaches prior to procedures.

Pain procedures can be part of the broad socio psychobiological strategies for pain management. It is critical to use skilled physiotherapists for prehabilition and rehabilitation, to optimise the outcome of interventions, to improve the length of benefit of the intervention.

Pain cannot be localised using current imaging techniques, so diagnostic pain procedures are used to help diagnose dominant anatomical pain sources. We will discuss the pain modulation of therapeutic procedures, for inflammation, nociceptive and neuropathic pain, for non-implant interventions for specific spinal pain, joint and regional pain. We will also discuss what options for now available for implant spinal stimulator systems, including DRG stimulation, and peripheral regional pain.

In clinical practice, when targeted therapeutic pain procedures provide a therapeutic window 3 to 12 months (or more), this enables the patients continue to progress with their active behavioural strategies.

The panel discussion will enable new clinicians and non-procedural health care professionals to have time to discuss specifics, including the place of procedures with experienced pain specialists and pain physiotherapist. This session aims to include the broader APS community, including non-proceduralists, pain fellows in training and proceduralists.

A/Professor Stephanie Davies, Painless Health, WA, Australia
Tracy Wallwork, Painless Health, WA, Australia
Dr Geoff Speldewinde, Capital Pain And Rehabilitation Clinic, ACT, Australia
Dr Stephen Gibson, Royal Prince Alfred Hospital, NSW, Australia

1C: From hysteria to silent epidemic: the modern story of chronic pelvic pain

Chair: Dr Meredith Craigie, Faculty of Pain Medicine, ANZCA, SA, Australia

From the diagnosis of hysteria to suffering in silence: Worldwide, 1 in 5 young women suffer dysmenorrhea resulting in missed school or work. Some will develop persistent pelvic pain. Some will become opioid dependent. Many will later present to adult pain clinics with additional pain conditions. All will suffer diminished quality of life and significantly reduced life opportunities. This session, including a panel discussion, will provide the views of world renowned gynaecologists and specialists in pain medicine and patient advocates on the current topics, including latest management, prevention and advocacy.

Severe dysmenorrhea offers the opportunity for prevention of persistent pain. By identifying and appropriately treating these women at a younger age, we have the opportunity to offer interventions to reduce the impact of pain in our society. This session will consider the underlying mechanisms and the interventions available, across the sociopsychobiomedical spectrum to prevent persistent pelvic pain in women.

We will explore the place of endometriosis in pain and menstruation as an inflammatory process. We will examine the role of surgery, in both adolescents in a 10year follow up study, and in adult women with pelvic pain with 3year outcome data.

Pelvic Pain Foundation Australia created PPEP Talk® (Periods, Pain and Endometriosis Program) to empower young people with knowledge about period pain, pelvic pain, and endometriosis to improve their knowledge of their bodies and help them take care of their mental and physical health. This session will explore the ways we discuss pain with young people and how we educate a new generation of young people about their bodies.

Dr Susan Evans. Pelvic Pain Foundation Australia, SA, Australia
Professor Sonia Grover, The Royal Children's Hospital, VIC, Australia
Libby Parker, Pelvic Pain Foundation Australia, SA, Australia

1D: Early Psychosocial Intervention for work related injuries: Challenges and Benefits

Chair: Dr Manasi Murthy Mittinty, University of Sydney, SA, Australia

Individuals sustaining work-related injuries are at an increased risk of chronic pain, long term disability, as well as impaired mental and physical health. Prolonged absence from work also increases their risk of never returning to work. Most of those at greater risk of these poor outcomes can be identified within a few weeks of their injury, making prevention a real possibility.

The Exploration, Preparation, Implementation, Sustainment framework (EPIS) has been endorsed for the conceptualisation and planning of interventions for injured workers. One of the key domains identified by EPIS is involvement of the workplace/employers with enhanced recovery, reduced costs and faster return to work reported.

This session will discuss a pragmatic guide for planning and implementing early psychosocial interventions incorporating the EPIS perspective, an interactive Q&A and expert panel discussion. The topics to be covered include:
1. Why workplace involvement is important for injured workers?
2. What is the current evidence on the role of early psychosocial intervention for high risk injured workers?
3. How can we integrate multiple stakeholders into the planning and delivery of early psychosocial intervention?
4. What are the key issues when working with corporate stakeholders on a research project?
5. Panel discussion

Dr Manasi Murthy Mittinty, University of Sydney, SA, Australia
Professor Michael Nicholas, University of Sydney, NSW, Australia
Melanie Ianssen, Australia Post Group, VIC, Australia

1E: Engaging different populations in pain-related education         

Chair: Joshua Pate, Westmead Hospital Pain Management Centre, NSW, Australia

This topical session features interdisciplinary perspectives on how clinicians, researchers and educators can engage different populations in pain-related education.

Senior Physiotherapist Joshua Pate will describe a novel approach to large-scale pain-related education by working with TED-Ed and YouTube to disseminate educational animations about pain science. Professor Julia Hush will explain how the International Association for the Study of Pain (IASP) pain curriculum can be embedded into a tertiary physiotherapy course, and how curriculum modules can be connected across different health disciplines. Dr Hazel Jenkins will explore the barriers General Practitioners face providing patient education for acute low back pain, and how to introduce new education material for General Practitioners to use with patients in clinical practice.

Joshua Pate, Westmead Hospital Pain Management Centre, NSW, Australia
Professor Julia Hush, Macquarie University, NSW, Australia
Dr Hazel Jenkins, Macquarie University, NSW, Australia

1F: Multiple Sclerosis: Populations, patients and mechanisms - from big data to small molecules

Chair: A/Professor Kevin Keay, University of Sydney, NSW, Australia

This session will be presented by three leaders in the field who will provide updates on our latest understanding of the etiology, incidence and causes of multiple sclerosis from the vantage point of the population; insights and reflections on managing and supporting the patient with multiple sclerosis and; understanding the neuroimmune mechanisms of the pain of multiple sclerosis and the potential for novel therapies for its management. At the end of the session participants will have a state of the art overview of the epidemiology and likely causes of multiple sclerosis, and the current and future possibilities for the management of multiple sclerosis related pain.

Dr Samuel Duffy, University of New South Wales, NSW, Australia
Tim O'Maley, MS Queensland, QLD, Australia
Professor Bruce Taylor, University of Tasmania, TAS, Australia

Topical Sessions 2

Monday 6 April 2020, 1.45 pm - 3.15 pm

2A: Prognostic factors, and patient and parent related outcomes in paediatric chronic pain

Chair: Dr Mark Alcock, Queensland Children's Hospital, QLD, Australia

Paediatric chronic pain is a counterintuitive problem that affects the whole family. Reflective of its sociopsychobiomedical nature, clinical presentations are an expression of the interaction of multiple factors. Identifying therapy priorities, and assessing progress is not always easy. This topical session will explore the paediatric pain literature surrounding prognostic factors, and pain related outcomes in both patients and parents

Dr Mark Alcock, Queensland Children's Hospital, QLD, Australia
Joshua Pate, Macquarie University, NSW, Australia
Theresa Donnelly, University of Technology Sydney, NSW, Australia

2B: The art of clinical communication: Shaping patients’ emotions, beliefs and behaviours

Chair: Dr Claire Ashton-James, University of Sydney, NSW, Australia

Clinical communication skills are essential to patient outcomes in chronic pain management. Clinicians’ ability to identify and manage patients’ fear, anger or distress influences patient engagement and receptiveness to treatment advice. The words that clinicians use to describe their clinical observations shape patients’ beliefs about their prognosis and functional limitations. Clinicians’ ability to simultaneously validate and challenge unhelpful beliefs is essential for creating “teachable moments” and long term behaviour change. This session brings together three of Australia’s leading experts on clinical communication in the context of chronic pain management. Dr Claire Ashton-James will present research indicating that the ability to manage patient emotions is associated with both clinician and patient wellbeing and treatment outcomes. Using a combination of video footage and audience-based interactive role play, Dr Ashton-James will demonstrate evidence-based strategies for de-escalating patient emotions. Drawing on findings from her research, Dr Bunzli will describe how the language used by clinicians can perpetuate negative beliefs and behaviours among patients. To assist clinicians in the audience to modify their language, Dr Bunzli will present a series of interactive videos modelling helpful and unhelpful messages in the clinical setting. Finally, Dr Caneiro will demonstrate how to use behavioural experiments as a way to elicit and challenge unhelpful beliefs and behaviours that contribute to pain related disability and distress.

Dr Claire Ashton-James, University of Sydney, NSW, Australia
Dr Samantha Brunzli, University of Melbourne, VIC, Australia
Dr JP Caneiro, Curtin University, WA, Australia

2C: Pelvic pain basics for the everyday clinician

Chair: Dr Angela Chia, Pain Matrix, VIC, Australia

Pelvic pain is a complex condition which can present in any clinical situation. This session presents a ‘pants on’ approach to pelvic pain and aims to equip the everyday clinician with the tools they need to start addressing pelvic pain with their patients.

Alison Sim will first share some tips and tricks on listening and talking to patients about pelvic issues. This will include a discussion on key information we should gather from pelvic pain patients and how to ask sensitive questions.

Second, Dr Jane Chalmers will explore some of the common presentations of pelvic pain in men and women, and discuss some of the basic ‘pants on’ assessment methods the everyday clinician can use with pelvic pain patients.

Dr Sandy Hilton will then describe some of the pelvic-related problems that may arise in pregnancy and provide practical options to address the problems, including self-treatment techniques to use during pregnancy and post-partum recovery.

Together, Alison, Jane, and Sandy will then present some of the latest, evidence-based, practical treatment ideas for the everyday clinician seeing a pelvic pain patient for the first time. This will also include audience involvement in practicing some interventions.

Alison Sim, Pain Matrix, VIC, Australia
Dr Jane Chalmers, Western Sydney University, NSW, Australia
Dr Sandy Hilton, Entropy Physiotherapy and Wellness, USA

2D: Pain and the Aged Care Royal Commission

Chair: A/Professor Benny Katz, St Vincent's Hospital, VIC, Australia

The Royal Commission into Aged Care Quality and Safety was established to inquire on the standard of aged care services in Australia. As pain is a very common health issue in this setting, and as good pain management is closely linked with quality of care, it is unsurprisingly that the topic of pain has featured at the Royal Commission.

In this session, we will explore some of the issues presented to the Royal Commission, some of their findings related to pain, our own experiences, and new research and directions that may address some of the Commission’s final report.

Dr Jennifer Abbey will talk about her discussion with the Royal Commission on caring for people in late-stage dementia and with pain, and how unprepared the Industry is to cope with these issues. She will also talk about the potential role of technology such as PainChek. Ms Marie Vaughan will relate the Commission’s findings to her work as a Nurse Practitioner in aged care. And in light of the Commission’s findings, Dr Steven Savvas will talk about some new initiatives such as the development of an updated pain management guide toolkit for residential services.

Dr Steven Savvas, National Ageing Research Institute, VIC, Australia
Dr Jennifer Abbey, National Dementia Collaborative Research Centre, SA, Australia
Marie Vaughan, Royal Freemasons, VIC, Australia

2E: Thinking outside of the box

Chair: A/Professor Tasha Stanton, University of South Australia, SA, Australia

Prepare to be dazzled. This session will bring together world-class speakers from a variety of research backgrounds to explore what we do right, what we do wrong, and what we could do better.

Doctor Fiona Kerr, trained in complex systems engineering and cognitive neuroscience (augmented by degrees in psychology and anthropology), will explore the future landscape of pain treatment given advances in both Artificial Intelligence (AI) and our understanding of the neurophysiological impacts of human connection. She will discuss the critical considerations that are needed to use AI to its potential given the extensive positive neural and biological changes brought about by warm interaction (e.g., touch, gaze, empathic dialogue).

Associate Professor David Butler, a pain communication expert and learning enthusiast, will then question why any of us are attending this conference if we don’t even know how to learn. He will explore what it means to learn, specifically discussing whether our patients might be victims of our learning experiences as clinicians and what we can do to change that.

Last, Dr Hannah Brown, a researcher-turned-communicator who leads Storytelling, Communication, and Development at the South Australian Health and Medical Research Institute (SAHMRI) will walk us through science communication, namely how we can develop a narrative and use storytelling to help convey complex or difficult concepts to a variety of audiences. 

Dr Fiona Kerr, University of Adelaide, SA, Australia
A/Professor David Butler, NOI Group, University of South Australia, SA, Australia
Dr Hannah Brown, South Australia Health and Medical Research Institute (SAHMRI), SA, Australia

2F: Going back to basics: New pharmacological insights to reveal mechanisms that drive opioid efficacy or side-effects

Chair: Dr Nicholas Veldhuis, Monash Institute of Pharmaceutical Sciences, VIC, Australia

With ongoing challenges in clinical opioid use, basic research in pain and molecular pharmacology of opioids continues to be valuable for improving our understanding of opioid mechanisms of action. This session will discuss some of the signalling processes that drive opioid efficacy and poor safety profiles at the molecular and cellular level, with the goal of revealing new insights that may be of interest to basic researchers and clinical researchers alike. This will be also be linked to discussion around attempts pharma have made (generally without success) to improve the therapeutic index of opioids and will conclude with a panel discussion with all 4 speakers to engage the audience in this topical session.

Professor Macdonald Christie, University of Sydney, NSW, Australia
Dr Peter Grace, University of Texas, MD Anderson Cancer Center, USA
Dr Veldhuis Poole, Monash Institute of Pharmaceutical Sciences, VIC, Australia
Professor Paul Rolan, University of Adelaide, SA, Australia

Topical Sessions 3

Tuesday 7 April 2020, 1.45 – 3.00 pm

3A: What hurts us makes us closer: The relationship between pain and social connection

Chair: Dianne Wilson, University of South Australia, SA, Australia

The social antecedents and consequences of acute and chronic pain are often underrepresented in pain management and pain research. Accordingly, very little is done to harness social modulators of pain to improve patient outcomes. The goal of this session is to examine the association between pain and social connectedness and consider the implications of these research findings for the treatment of pain. Dr Claire Ashton-James will open the session by presenting evidence that people seek out and create social bonds with others in anticipation of acute pain experiences, and that the experience of low levels of acute pain increase prosocial attitudes and behaviour towards minorities. Consistent with these findings, Dr Laura Ferris presents field research into the association between the "pleasurable" pain of swimming naked in ice-cold water during Hobart's Dark Mofo Festival and identification with others. Finally, Di Wilson will present the results of her PhD research into the contribution of group identification and sense of belonging to outcomes in group CBT-based pain management programs.

Dr Claire Ashton-James, University of Sydney, NSW, Australia
Dianne Wilson, University of South Australia, SA, Australia
Dr Laura Ferris, University of Queensland, QLD, Australia

Topical Sessions 3

Tuesday 7 April 2020, 3.30 pm - 5.00 pm

3B: Pain Revolution three years in. Updates, challenges and opportunities

Chair: Dr Carolyn Berryman, University of Adelaide, SA, Australia

The purpose of pain revolution is to reduce the incidence, prevalence and impact of persistent pain in rural and regional Australia and its vision is that all Australians will have the knowledge, skills and local support to prevent and overcome persistent pain. In this topical symposium, we will present the reason for Pain Revolution, its guiding principles and the theoretical frameworks and evidence base that underpin all its strategies. We will outline the various Pain Revolution strategies, including the Local Pain Educator program, the Local Pain Collectives project and the Community Engagement Project, all of which have involved collaboration with and funding from several government agencies and community groups. We will give an overview of the Pain Revolution Rural Outreach Tour, for which the Australian Pain Society is an ongoing Association Partner. We will present preliminary evaluations. Finally, we will provide an ‘on the ground’ case study from one of the communities which has been impacted by these strategies. This symposium will be a frank appraisal of a work in progress, including successes, failures, the barriers to progress and our attempts thus far to overcome them. There will be time for questions and discussion on how to get involved.

Dr Carolyn Berryman, University of Adelaide, SA, Australia
Angie Clerc-Hawke, University of South Australia, NSW, Australia
Daniel Searle, Private Practice, NSW, Australia

3C: Food, mood, chronic pain and the microbiome  

Chair: Katherine Brain, University of Newcastle, NSW, Australia

We have tens of trillions microorganisms living inside our body which makes up 2 kilograms of our total body weight. How does this affect our health? How does this affect chronic pain? These are some of the questions this session will aim to answer.

This topical session will explore the complex relationships between food, mood, pain and the microbiome. The session will begin with an explanation on the brain, gut and microbiome and how this relates to chronic pain. The session will then drill down discussing the basic science relationships between specific nutrients and the microbiome. Following this the session will explore the relationship between dietary intake, the microbiome and chronic pain including common gut disorders. The session will end with discussion around the relationship between emotional health and the microbiome. When does stress become a problem for the gut and what can you do about it?

Professor John Cryan, University College Cork, Ireland
Professor Mark Morrison, University of Queensland, QLD, Australia
Dr Kerith Duncanson, University Of Newcastle, NSW, Australia
Dr Sarah Campbell, Hunter Integrated Pain Service, NSW, Australia

3D: Persistent Pain following Spinal Cord Injury: Prevalence, Practice, and Progress        

Chair: Dr Daniel Harvie, Griffith University, QLD, Australia

Spinal Cord Injury (SCI) is often followed not only by impairment of function, but also persistent pain, fatigue and psychological disturbances that limit community participation. In this topical session, we will present the current state of play with respect to epidemiology, mechanisms, and management of pain following SCI.

Prof. James Middleton will present the latest data from a large Australian survey of pain in people with SCI (n=1579) in terms of prevalence, lived-experience, associations with other secondary conditions, including sleep disorder, mood disturbance and fatigue, impact on quality of life and current self-reported interventions. Assoc. Prof. Sylvia Gustin will present data relating to virtual reality treatment for SCI while discussing potential brain mechanisms responsible. In addition the discovery of a third category of SCI – discomplete SCI – and it’s relevance to rehabilitation will be examined. Finally, Prof. Ashley Craig will discuss a new model of the relationship between pain, fatigue, depressive mood and self-efficacy in SCI and recent findings on “top down” versus “bottom up” pain related factors and their influences on fatigue and sleep in adults with SCI.

Professor James Middleton, University of Sydney, NSW, Australia
A/Professor Sylvia Gustin, University of New South Wales, NSW, Australia
Professor Ashley Craig, University of Sydney, NSW, Australia

3E: Targeting pain-related fear and conceptual knowledge about pain in chronic pain disability

Chair: A/Professor Ann Meulders, Maastricht University, Netherlands

Learning to predict danger is adaptive; it assists in anticipating and avoiding harm. Given its intrinsically alarming function, pain is a potent motivator for learning –it stimulates the detection of stimuli predicting the occurrence of pain to avoid/minimize their impact. Protective responses (e.g. fear/avoidance) are adaptive and promote recovery, yet when pain no longer signals bodily harm they may develop into chronic pain. Prominent clinical models of chronic pain indeed assign an important role to learning processes in the development and maintenance of pain-related disability. This symposium compiles innovative developments in how associative learning and acquired conceptual knowledge about pain contribute to pain responses, pain persistence, and disability and how this can be targeted in treatment. Dr. Meulders will present novel data on overgeneralization of fear of movement-related pain and avoidance in people with high trait anxiety and chronic pain. Dr. Van Oudenhove will focus on interoceptive fear conditioning of visceral sensations and how this contributes to chronic visceral pain. Finally, Dr. Stanton will present a feasibility RCT comparing a pain science-enhanced walking program (vs. general education and walking program) in people with knee osteoarthritis, testing the idea that changing conceptual knowledge about pain can alter pain and activity levels.

A/Professor Ann Meulders, Maastricht University, Netherlands
A/Professor Lukas Van Oudenhove, Ku Leuven, Belgium
A/Professor Tasha Stanton, University of South Australia, SA, Australia

3F: Pain and the immune response

Chair: Dr Nicholas Veldhuis, Monash Institute of Pharmaceutical Sciences, VIC, Australia

Chronic inflammation is a significant source of pain that is presented in many different ways including in conditions of global importance such as osteoarthritis and fibromyalgia. It is difficult to manage and poorly understood at the cellular/ molecular levels, and hence, understanding how inflammation and immune cells drive pain responses may lead to the identification of new therapeutic targets and treatment strategies.

This topical session incorporates basic pain and clinically-focussed researchers to provide new insights into cellular processes that drive inflammation and pain, and reveal new strategies that may help to combat inflammation and neuro-immune functional interactions.

Professor John Hamilton, Royal Melbourne Hospital, VIC, Australia
Dr Gila Moalem-Taylor, UNSW, NSW, Australia
Dr Irina Vetter, University Of Queensland, QLD, Australia
Professor Geoff Littlejohn, Monash University, VIC, Australia

3G: Meanings of Cancer-Related Pain

Chair: Professor Jane Phillips, University of Technology Sydney, NSW, Australia

Cognitive factors are important determinants of cancer-related pain experience. Simon van Rysewyk describes some common meanings and beliefs that people have about cancer, illness, and pain, and the consequences these meanings have in relation to common help-seeking behaviours or coping strategies people choose to adopt. Suffering is a cognitive and emotional response to recurrent perceived losses experienced in some people with cancer. Megan Best presents on the challenges in assessing people with cancer-related suffering and the relationship of suffering to cancer-related pain. Melanie Lovell compares levels of suffering in people with cancer-related pain versus non-cancer chronic pain, highlighting differential meanings of existential or spiritual distress and mood dysfunction. Best and Lovell outline management approaches to cancer pain and suffering that are not responsive to analgesia, such as meaning- or peace-centred therapies.

Dr Simon van Rysewyk, University of Tasmania, NSW, Australia
Dr Megan Best, University of Sydney, NSW, Australia
A/Professor Melanie Lovell, University of Sydney, NSW, Australia